Cancer Pain Management in Resource-Limited Settings A Practice Review英文文献资料.docVIP

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Cancer Pain Management in Resource-Limited Settings A Practice Review英文文献资料.doc

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Cancer Pain Management in Resource-Limited Settings A Practice Review英文文献资料

HindawiPublishingCorporation PainResearchandTreatment Volume2011,ArticleID393404,6pages doi:10.1155/2011/393404 ReviewArticle CancerPainManagementinResource-LimitedSettings: APracticeReview ElizabethNamukwaya,MhoiraLeng,JuliaDowning,andEllyKatabira DepartmentofMedicine,SchoolofMedicine,MakerereUniversityCollegeofHealthSciences,P.O.BOX7072,Kampala,Uganda CorrespondenceshouldbeaddressedtoElizabethNamukwaya,liznam2002@yahoo.co.uk Received1October2010;Accepted14September2011 AcademicEditor:HowardS.Smith Copyright?2011ElizabethNamukwayaetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Painincancerisacommonandburdensomesymptomwithdi?erentcausesbutinasigni?cantnumberofcasesitisundiagnosed andundertreatedbecauseoflackofskillsforitsassessment.Painhassigni?cantnegativeimpactonthepatientand,therefore, itneedstobemanagedurgentlyandappropriately.Inresource-limitedsettings,thereareseveralbarriersandchallengestopain managementbuteveninthesecircumstancespaincanbewellmanagedwithplannedandinnovativeuseofresourcesandifthe WorldHealthOrganizationpublichealthsystemapproachisusedtoensureopioidavailability. 1.Introduction Painunrelatedtothecanceroritstreatmentisofsigni?cant importance in resource-limited settings, where the burden of HIV/AIDS is high and, therefore, patients might have HIV-associated malignancies and their pain may be due to the HIV or associated opportunistic infections and/or antiretroviraltreatment. Pain in cancer patients is one of the most feared and burdensome symptoms [1] and is often undertreated [2]. In a recent systematic review, the prevalence of pain was foundtobe64%inpatientswithadvancedandmetastatic disease, 59% in those on anticancer treatment, and 33% in those who had been cured of cancer [1]. In Africa, the prevalenceofcancerpainrangesfrom35.7%to87.5%with theprevalencebeingmorethan70%inmostofthestudies [3–9].Thishi